Pharmacies and state governments in the United States have dumped at least 15.1 million doses of Covid-19 vaccines since March 1, according to government data obtained by NBC News — a far greater number than previously known and still likely a minority.
Four national pharmacy chains reported more than 1 million wasted doses each, according to data released Tuesday by Center for Disease Control and Prevention in response to a request for public records. Walgreens reported the most spills from any pharmacy, state, or other vaccine provider with nearly 2.6 million spilled doses. CVS reported 2.3 million wasted doses, while Walmart reported 1.6 million and Rite Aid reported 1.1 million.
Data released by the CDC are self-reported by pharmacies, states, and other vaccine providers. It is not comprehensive – some states and federal providers are missing – and it does not include the reason why doses should be discarded. The number of discarded doses is still a small fraction of the total vaccines administered in the United States
In general, there are a number of reasons why vaccination sites may need to mark doses as spilled, from a cracked vial or a failure to dilute the vaccine to a freezer function to more doses in a vial than people who want them. A spill report can also occur when a vial contains fewer doses than it should.
The data on wasted doses comes as the more contagious delta variant spreads rapidly across the United States, adding a new urgent effort to vaccinate as many people as possible and encourage a plan to start offering booster shots to those who have already been vaccinated – also as many nations around the world have vaccinated few, if any, of their residents.
“It is truly tragic that we have a situation where vaccines are being wasted, while many African countries have not even had 5 per cent of their populations vaccinated,” said Sharifah Sekalala, associate professor of global health law at the University of Warwick in England. infectious diseases.
“Much of the global south is unvaccinated. The African continent is still below 10 percent, and that’s just a huge inequality, and that’s really problematic.”
CDC spokeswoman Kristen Nordlund said in an email that the proportion of spilled Covid vaccines “remains extremely low, which is proof of the strong partnership between the federal government, jurisdictions and vaccine providers to get so many people vaccinated. as possible, while reducing vaccination waste across the system. “
Nordland added: “As access to Covid-19 vaccine has increased, it is important for providers not to miss any opportunity to vaccinate all eligible persons who present at vaccine clinics, although this may increase the likelihood of leaving unused doses in a vial. ”
A CVS spokesman made a similar point, writing in an email: “Although we regret having to dispose of any vaccine, we are extremely proud of our store staff who have helped administer more than 30 million doses. When we are given the opportunity to potentially save a life or slightly improve our reported waste rates, we always choose the first. ”
Walgreens, Walmart, and Rite Aid did not immediately respond to requests for comment. “Our goal has always been to ensure that every dose of vaccine is used,” said Walgreens spokesman Kris Lathan told Kaiser Health News in May.
The number of doses wasted is a small fraction of more than 438 million doses which were distributed in the country from Tuesday and 111.7 million additional doses The United States had given to other countries as of August 3rd.
Demand for vaccines in the United States rose in August as cases and admissions increased due to the delta variant. Yet the United States wasted at least 3.8 million doses in August alone, the data show.
States, pharmacies and other vaccine providers also reported at least 4.4 million wasted doses to the CDC in June and 4.7 million in July – more than in March, April and May combined.
No state health department came close to the number of doses spilled by pharmacy chains, but four reported over 200,000 wasted doses each. Texas led in reports of vaccination wastes from states with 517,746 wasted doses, North Carolina reported 285,126, Pennsylvania reported 244,214 and Oklahoma reported 226,163.
Lara Anton, a spokeswoman for the Texas Department of State Health Services, said the state “instructed vaccine providers to prioritize vaccinating people when they came in to be vaccinated rather than wait until they found enough people to use each dose. in the vial before opening it, “which could lead to wasted doses. Power outages at two vaccine depots in Texas affected more than 47,000 doses in May, KXAN Austin reported at the time. Vaccine storage has moved to facilities with better temperature monitoring since the incident, a Texas Health Department spokesman said at the time.
Representatives of the health departments of North Carolina, Pennsylvania and Oklahoma did not immediately respond to requests for comment. Oklahoma officials previously accused vaccine waste about the need to get vaccines in the arms, even if it means throwing away unused doses.
Last month, the Food and Drug Administration approved booster shots for people who are immunocompromised because their bodies may not respond to the original vaccine regimen. The Biden administration also has announced a plan, awaiting FDA and CDC deregistration, to offer booster shots to all Americans eight months after their last dose in response to signs of declining immunity.
The movements provoked debate over whether it was moral to offer Americans extra protection when so many people around the world have not even received a single Covid vaccine shot.
But the new data showed that the United States has wasted far more vaccine doses than many poorer countries have for their entire population. For example, the country of Georgia, a coronavirus hot spot, has just managed 1.1 million vaccine doses for its population of 4.9 million. Nepal, which has been ravaged by the delta variant, has just administered 9.7 million doses for its population of 30.4 million.
“It’s a matter of equity,” said Tim Doran, a professor of health policy at the University of York in the United Kingdom. “You have a very wealthy country with good access to vaccines that mainly throw the vaccine away, and a lot of vaccine away, and you have other countries and other communities in the countries that would really demand it, that would have to wait and not get access to vaccine and it makes them susceptible while waiting for vaccination. ”
Sekalala, the global professor of health law, said the United States wasting so many doses was “inevitable by model” where wealthy countries bought large quantities of vaccines for themselves and only thought of donating them to poorer countries later.
“It’s a mistake in the current system where rich countries buy their individual batches of vaccines and then have to think about what will happen if they do not use them,” she said. “This led to an overpurchase where people bought supplies that they did not need or could not use.”
A contributing factor to vaccination waste is the way the vaccines are packaged. Most vaccines against other diseases come in single-dose vials. However, depending on the equipment used to draw a dose, Modern Covid vaccine has up to 15 doses in a vial while Pfizer’s has up to six and Johnson & Johnsons has up to five.
When a vial is punctured – e.g. If a customer requests the vaccine at a retail pharmacy – the clock starts ticking. A vial of Moderna vaccine should be discarded 12 hours after puncture, while Pfizers and Johnson & Johnsons should be discarded after six hours.
The high number of doses in each vial and the relatively short time frame for using a vial once it has been punctured have probably contributed to unused doses being wasted.
Several vaccine providers reported wastage of thousands of doses to the CDC in a single report. But in general, the recently released data show that vaccine waste was a slow, stable herring rather than a flood – the most common report in the data was just four doses wasted at a time.
The data released on Tuesday is more detailed and complete than data released by the CDC in April, when a Kaiser Health News survey found that the country wasted nearly 200,000 Covid vaccine doses from December 2020 to March 2021.
ONE separate study of The New York Times found about 1 million wasted doses across 10 states from December to July.
The more detailed data suggest that the CDC now has a better picture of how much is being wasted and where than it did earlier in the vaccination program. Yet seven states are completely missing from the recently released data: Arkansas, Connecticut, Louisiana, Maine, Nevada, Ohio and Oregon.
Another state, Michigan, has reported only 12 wasted doses to the CDC since March 1st.
Also from CDC data are missing doses wasted by federal agencies administering the vaccines, including the Ministry of Defense, the Bureau, the Veterans Health Administration and the Indian Health Service.
Several vaccination waste data are stored in Tiberius, a system operated by the Department of Health and Human Services, but officials have not yet released it. The data released Tuesday came from the CDC’s Vaccine Tracking System, or VTrckS, which retrieves data from state and local immunization records.
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